Re "Training Rxzzzz," Commentary, July 1: The Accreditation Council for Graduate Medical Education recognizes that reducing duty hours alone will not ensure high-quality education and effective patient care. The regulations also call for comprehensive oversight by supervising doctors and stringent compliance regulations for residency programs.
Schedules for teaching staff will be structured to provide ready supervision and faculty consultation for residents on duty. Duty-hour assignments will reflect the collective responsibility that faculty and residents have for patients' safety and care.
Residency programs are designed to ensure that students get the necessary experience to make them skilled professionals. Getting this experience requires long hours of being available so that when opportunities arise to perform and repeat procedures, resident physicians are there to take advantage of them. Long hours are also due to a rigorous education program that requires hands-on training, attendance at meetings and seminars and administrative duties associated with patient cases.
Changes in the health-care environment have led to an intensified workload for residents. Medical advances have expanded care options, shorter stays for patients require condensing care, and financial pressures have slashed support staff and services available to residents. The ACGME's reforms take all of these issues into account.
David C. Leach
Executive Director, ACGME